Pap Smear Exam - What is it and do I need one?

The Papanicolaou test, usually called a Pap smear, or simply, the “Pap,” is a test which checks your cervix for any changes in the cells that might indicate cancer. In a Pap smear exam, your doctor will take a sample of cervical cells and then send them to a laboratory.

The idea is to detect pre-cancerous cells (the condition is often called dysplasia) before they advance to actual cancer. These changes are usually caused by HPVs (human papillomaviruses). It can also detect other infections and abnormalities.

Who should get a Pap smear exam? The test is recommended for women over the age of 18, or approximately three years after first sexual activity. From there, recommendations vary from annually to every five years, depending on risk factors such as monogamy and immune system health. If the test is abnormal, your doctor will usually recommend that you repeat the exam from 3 to 9 months later.

If the abnormality persists (the time frame depending on the severity of the abnormality and risk factors), your doctor may decide to perform a colonoscopy, where small samples of cervical tissue are removed and then biopsied. Your doctor may also recommend HPV typing, to be sure that one of the more aggressive (cancer-causing) forms of the virus is not responsible for the abnormalities.

It is important to remember that cervical cancer takes time – years – to develop, so having an abnormal result on your Pap smear exam is not necessarily a cause for concern. In many cases, your own immune system will deal with the infection and repair the cervix itself.

That is why many abnormalities are simply monitored, not treated aggressively.
After three consecutive years of normal results on your Pap, your doctor may recommend you spread out your screening frequency, to three or even five years, especially if you are in a monogamous relationship. You should not make this decision without talking with your doctor first, however.

Also, even if you have been vaccinated against HPV, you should still have your Pap smear exam regularly (as recommended by your doctor), because the vaccine does not cover every single type that can cause cervical cancer.

Do you really need a Pap smear? If you are sexually active, or over 18, the answer is YES. The procedure is certainly uncomfortable, and some women do experience cramping as the sample is taken.

However, the Pap smear exam can save your life. Prior to the introduction of this simple test, thousands of women died of cervical cancer – and still do in countries where the exam is not readily available. Cervical cancer is one of the deadliest kinds of cancer. But it also the most preventable.

Because of its generally slow progression, the Pap smear will nearly always detect it at a time where treatment can still be effective. Keep this in mind: in the US, over half of all the women who are diagnosed with invasive cervical cancer NEVER had a Pap smear.

Another 10 to 20% of these invasive cancers occur in women who had not had a Pap smear in five years. And in 25% of these cases, the woman had received an abnormal Pap smear result, but did not follow-up appropriately.

For these reasons, it is clear that the Pap smear saves lives. It can even save your own. Make an appointment with your doctor today.